Adverse life events and emotional and behavioural problems in adolescence: the role of coping and emotion regulation

Contextual and Behavioral Correlates of Coping Strategies Among an Ethnically Diverse Sample of Urban Adolescents in the Midwestern United States

Coping is recognized as an important life skill. In the present cross-sectional analysis, early adolescents' relationships with their caregivers (support, conflict) and exposure to stressors (uncontrollable life events, violence) were examined as contextual correlates of both positive and negative coping strategies. Coping strategies were examined as mediators of associations between adolescents' family and community contexts and adjustment outcomes (externalizing symptoms, internalizing symptoms, academic investment). Participants were recruited from an urban Pre-K-8 school and Boys and Girls Club. Adolescents who reported greater support from caregivers reported greater engagement in all forms of positive coping (behavioral/problem-focused coping, cognitive/emotion-focused coping, and coping through seeking support); they also reported less engagement in coping through anger and helplessness. Adolescents who reported greater conflict with caregivers or violence exposure reported greater engagement in coping through avoidance, anger, and helplessness. Problem-focused coping, coping through anger, and coping through helplessness mediated associations between different contextual factors and outcomes.

Fluctuations in emotion regulation as a mechanism linking stress and internalizing psychopathology among adolescents: An intensive longitudinal study

Stressful life events (SLEs) are tightly coupled with the emergence of anxiety and depression symptoms among adolescents, but the mechanisms underlying this relationship remain poorly understood. We investigated within-person fluctuations in emotion regulation as a mechanism linking SLEs and internalizing psychopathology in an intensive longitudinal study. We examined how monthly fluctuations in SLEs were related to engagement in three emotion regulation strategies-acceptance, reappraisal, and rumination-and whether these strategies were associated with changes in internalizing symptoms in adolescents followed for one year (N = 30; n = 355 monthly observations). Bayesian hierarchical models revealed that on months when adolescents experienced more SLEs than was typical for them, they also engaged in more rumination, which, in turn, was associated with higher anxiety and depression symptoms and mediated the prospective relationship between SLEs and internalizing symptoms. In contrast, greater use of acceptance and reappraisal selectively moderated the association between stressors and internalizing symptoms, resulting in stronger links between SLEs and symptoms. These results suggest that emotion regulation strategies play different roles in the stress-psychopathology relationship. Understanding how changes in emotion regulation contribute to increases in internalizing symptoms following experiences of stress may provide novel targets for interventions aimed at reducing stress-related psychopathology.

Subjective wellbeing of autistic adolescents and young adults: A cross sectional study

Subjective wellbeing (SWB) represents an individual's perception of wellness that is supported by homeostatic mechanisms. These mechanisms are proposed to be maintained by low negative affect and high positive affect, although less is known about these mechanisms and SWB in autism. The current cross-sectional study aimed to compare patterns of positive affect, negative affect (Positive Affect and Negative Affect Scale), and SWB (Personal Wellbeing Index-School Children) between autistic (n = 53) and non-autistic (n = 49) individuals aged 10-22 years (Mage = 13.97, SD = 3.13). Between-group t-tests revealed that compared with same-age peers, autistic participants scored lower SWB overall (p < 0.001). In both groups average SWB scores fell into the higher range, however, autistic participants were three-times more likely to fall below this range when compared to non-autistic participants. Negative affect had a higher intercept in the autistic sample, but no difference in slopes were observed. A hierarchical multiple regression revealed that diagnosis, positive affect, and negative affect significantly predicted SWB in our sample. Between-group t-tests found no significant difference in positive affect or negative affect across age between the autistic and non-autistic samples. In autistic participants, positive affect increased across age as SWB decreased, whilst negative affect remained stable, a pattern inconsistent with homeostatic SWB. The current study is overall consistent with the homeostatic explanation for SWB within autism; however, we identified potential differences between autistic and non-autistic participants in the contribution of positive affect and negative affect to homeostatic protect mood across development.

Gamified Assessment of the Emotion Regulation Abilities in Youth: Validation of the REThink Online System

Objective: Emotional problems in the youth population are a major issue that can have a significant negative impact for their future development as adults. Their emotion regulation (ER) abilities represent a preventive measure for those emotional problems. REThink is an online therapeutic game that was proved to be effective in rigorous studies, and is based on the rational emotive behavioral therapy, with seven levels built to train various emotional regulation skills. Each level has a section that can be used for the assessment of the targeted skills within the level. The present study aimed at investigating the reliability and validity of the evaluation modules from the REThink game regarding the assessment of ER abilities in children/adolescents. Methods: In accordance with established guidelines, 110 children and adolescents aged 8-14 years old were recruited. Following parental informed consent, the participants filled out the standard questionnaires and, subsequently, they played the evaluation module of the REThink game. The reliability aspect was investigated by evaluating internal consistency, while validity was evaluated by using concurrent and predictive validity analyses. Results: The results revealed statistically significant positive associations between the game scores obtained by the participants and the emotion regulation scale. In terms of predictive validity, there were significant negative associations between game scores and the presence of emotional and behavioral problems. Moreover, in terms of the reliability of the REThink game, an acceptable value for the internal consistency was observed. Conclusion: In conclusion, the REThink therapeutic game was proved to be a valid measure for assessing emotion regulation abilities in children and adolescents. Clinical Trial Registration No. NCT04788901.

Association between stressful life events and sleep quality in Chinese university students: Mediating and moderating roles of emotion regulation

This study investigated whether emotion regulation mediates or modulates the relationship of SLEs with sleep quality and potential sex differences. A total of 1447 Chinese university students completed the Adolescent Self-Rating Life Events Checklist, the Pittsburgh Sleep Quality Index, and the Emotion Regulation Questionnaire. The results indicated that both cognitive reappraisal and expressive suppression significantly mediated and moderated the negative association between SLEs and sleep quality. Additionally, sex differences were found for the mediating role of cognitive reappraisal and for the modulating roles of cognitive reappraisal and expressive suppression in the relationship between SLEs and sleep quality. Although the present cross-sectional data does not allow us to test any causal relationships, these results help clarify the underlying emotion-regulation process between SLEs and sleep in university students and highlight the importance of considering sex differences in emotion regulation.

Determination of Toxic Elements in Cannabinoid and Opioid Drugs and Their Impact on Addicts' Health: A Comparative Study

Drug addiction is associated with significant health risks, including cardiovascular complications, cancer, and mental disorders. Illicit drugs, such as cannabinoids and opioids, including prescription medications, are widely consumed and have profound health consequences. Understanding the health effects of the toxic elements in these substances is critical for overdose prevention and effective recovery strategies. This study aimed to determine toxic elements, including arsenic (As), cadmium (Cd), mercury (Hg), and nickel (Ni), in cannabinoid and opioid drugs and in biological samples (whole blood, scalp hair, and serum) from 311 male drug abuse patients aged 15-60 years with a history of drug abuse. The participants were categorized into three age groups. The comparative analysis involved 113 reference subjects of the same age groups. The sample preparation employed microwave-assisted acid digestion, and the toxic elements were quantified using atomic absorption spectrophotometry. Accuracy was ensured using certified reference materials for hair, whole blood, and serum samples. Drug-addicted subjects had significantly higher concentrations of toxic elements (arsenic, cadmium, mercury, and nickel) in biological samples than referent subjects (p > 0.001). Elevated levels of these toxic elements may increase susceptibility to infections, possibly due to malnutrition, drug-related effects, and additional contaminants. These findings necessitate further studies to explore the long-term health outcomes, potential treatment options, and broader socioeconomic impacts of substance abuse. This study serves as a baseline for future research in this critical public health field.

Bedtime procrastination related to loneliness among Chinese university students during post-pandemic period: a moderated chain mediation model

BACKGROUND

This study examined the relationship between loneliness and bedtime procrastination among Chinese university students, the mediating effects of COVID-19 risk perception and self-regulatory fatigue, and connectedness to nature's protective role, post pandemic.

METHODS

We recruited 855 students to complete the Loneliness, Perceived Risk of COVID-19 Pandemic, Self-Regulatory Fatigue, Bedtime Procrastination, and Connectedness to Nature Scales. Data for descriptive statistics, correlation analysis, and moderated chain mediation effects were analyzed using SPSS 24.0 and process 3.5 macros.

RESULTS

Loneliness positively correlated with bedtime procrastination, COVID-19 risk perception mediated the impact of loneliness on bedtime procrastination, self-regulatory fatigue mediated the effect of loneliness on bedtime procrastination, and COVID-19 risk perception and self-regulatory fatigue mediated the effect between loneliness and bedtime procrastination. Furthermore, connectedness to nature mediated the impact of COVID-19 risk perception on self-regulatory fatigue.

CONCLUSIONS

The results indicate the effects and potential mechanisms of loneliness on bedtime procrastination after the relaxation of the pandemic prevention and control policy in China from the perspective of self-regulatory resources and provide insights into improving university students' sleep routine and mental health post pandemic.

Predictors of Adolescent Resilience During the COVID-19 Pandemic in a Community Sample of Hispanic and Latinx Youth: Expressive Suppression and Social Support

The COVID-19 pandemic has created unprecedented disruptions in the daily lives and mental health of adolescents. Less attention has been given to the psychosocial resources that may mitigate the impact of COVID-19 on adolescent mental health, particularly among minoritized populations. In the present study, 259 youth (aged 11-18) were recruited from a community center for integrated prevention and intervention services in a predominantly Latinx and Hispanic community. Youth completed questionnaires about the impact COVID-19 has had on their lives, psychosocial resources (humor, optimism, emotion regulation, social support), and psychiatric symptoms (depressive symptoms, anxiety symptoms, sleep disturbances, aggression). After accounting for age, sex, and exposure to early life adversity, higher reported COVID-19 impact was associated with more depressive symptoms, b = 6.37 (SE = 1.67), 95% CI [3.08, 9.66], p < 0.001, more anxiety symptoms, b = 9.97 (SE = 1.63), 95% CI [6.75, 13.18], p < 0.001, and more sleep disturbances, b = 1.24 (SE = 0.34), 95% CI [0.57, 1.91], p < 0.001. Youth that reported infrequent expressive suppression and the lowest scores on giving social support were at the greatest risk for aggressive behavior in the context of high COVID-19 impact, ps < 0.007. Increasing emotion regulation skills, such as expressive suppression, and opportunities to give social support may promote resilience among high risk youth in the context of this ongoing community stressor.

Prosocial cascades: Understanding and nurturing the potential for positive developmental trajectories

Understanding the developmental cycles and mechanisms that nurture prosocial behavior can support our potential to build a kinder and more peaceful society. The current chapter explores positive developmental cascades, with a focus on the chain reactions that explain how prosocial behaviors manifest and evolve throughout childhood and adolescence. Specifically, we review the main issues, theories, and findings related to the study of children's prosocial trajectories. We focus on various socialization environments that span typical and adverse (e.g., trauma, poverty, maltreatment, exposure to violence) contexts. Furthermore, we highlight the evidence behind efforts and initiatives that aim to nurture prosociality in children and families. We conclude with future directions for how research on positive cascades can inform research-practice alliances work that aims to break harmful cycles and promote prosocial mechanisms of change.

Refugee Children's Social-Emotional Capacities: Links to Mental Health upon Resettlement and Buffering Effects on Pre-Migratory Adversity

Refugee children who experience severe pre-migratory adversity often show varying levels of mental health upon resettlement. Thus, it is critical to identify the factors that explain which refugee children experience more vs. less healthy outcomes. The present study assessed child social-emotional capacities (i.e., emotion regulation, sympathy, optimism, and trust) as potential moderators of associations between child, parental, and familial pre-migratory adversities and child mental health (i.e., internalizing and externalizing symptoms) upon resettlement. Participants were N = 123 five- to 12-year-old Syrian refugee children and their mothers living in Canada. Children and mothers reported their pre-migratory adverse life experiences, and mothers reported their children's current social-emotional capacities, internalizing symptoms, and externalizing symptoms. Greater familial (i.e., the sum of children's and their mother's) pre-migratory adversity was associated with higher child internalizing and externalizing symptoms upon resettlement. Higher emotion regulation and optimism were associated with lower internalizing and externalizing symptoms, and higher sympathy was associated with lower externalizing symptoms. In contrast, higher trust was associated with higher internalizing symptoms. Finally, higher child optimism buffered against the positive association between familial pre-migratory adversity and child internalizing symptoms. In sum, select social-emotional capacities may serve as potential protective factors that support mental health and buffer against the deleterious effects of pre-migratory adversity in refugee children.

Predictors of Adolescent Resilience During the COVID-19 Pandemic: Cognitive Reappraisal and Humor

PURPOSE

The COVID-19 pandemic and efforts to slow the spread of disease have particularly affected the lives of adolescents. Many studies have recently identified the risks to adolescent mental health posed by the COVID-19 pandemic, yet few have identified the markers of resilience to the events and concerns associated with the pandemic's lived experience. This study examined the moderating role of psychosocial resources in the association between the tangible and emotional experiences of the COVID-19 pandemic and symptoms of common psychiatric problems during adolescence (depression, anxiety, proactive and reactive aggression, and sleep problems).

METHODS

Participants were adolescents in the United States who were oversampled for early life adversity before the COVID-19 pandemic. The psychosocial resources assessed were humor styles, emotion regulation, social support, optimism, and purpose in life, which have previously been identified as protective in the acute aftermath of stressful events.

RESULTS

Greater COVID-19 impact was associated with more anxiety, depressive symptoms, sleep disturbance, and proactive aggression. COVID-19 impact and psychiatric symptoms were unrelated among youth reporting high self-enhancing humor and cognitive reappraisal.

CONCLUSIONS

Adolescents high in humor and cognitive reappraisal may be protected against the mental health correlates of the COVID-19 pandemic and other prolonged stressors. Importantly, these factors are known to be modifiable through behavioral interventions. Attention to their effectiveness in prevention and intervention studies is needed as the pandemic continues to exert its impact on individuals and society.

Childhood residential mobility and health outcomes: A meta-analysis

This study assesses the association between childhood residential mobility and health-related outcomes by way of a meta-analysis of studies published between 1989 and 2020. The sample includes 844 effect sizes from 64 unique studies. The results point to a negative association (small to medium) between childhood mobility and health. This association is contingent upon the type of health outcome studied, age at outcome assessment, age at moving, and frequency of moves. The major confounders of this association are parental SES, parental marital status, ethnicity, and co-occurring childhood adversities. The implications for future research are discussed.

Contributions of Emotion Regulation and Brain Structure and Function to Adolescent Internalizing Problems and Stress Vulnerability During the COVID-19 Pandemic: A Longitudinal Study

BACKGROUND

Adolescence is a period of increased vulnerability for internalizing problems, particularly following stressful life events. We examined how emotion regulation and brain structure and function were associated with internalizing problems during the COVID-19 pandemic and moderated the association between pandemic-related stressors and internalizing problems.

METHODS

Data are from a longitudinal sample (N = 145, age range, 10-15 years) strategically assessed at 3 crucial time points: before the COVID-19 pandemic, early during the stay-at-home order period, and again 6 months later. We examined associations of amygdala and hippocampal volume and amygdala activation during an emotional processing task before the pandemic, examined use of emotion regulation strategies before and during the pandemic, and examined pandemic-related stressors with internalizing problems.

RESULTS

Greater exposure to pandemic-related stressors was associated with higher internalizing problems both early and later in the COVID-19 pandemic. Youths who reported more frequent use of rumination before the pandemic and higher use of expressive suppression and lower use of cognitive reappraisal early in the pandemic had higher internalizing problems early in the pandemic. Higher left amygdala activation to neutral relative to fearful faces before the pandemic was associated with greater internalizing problems and a stronger link between pandemic-related stressors and internalizing problems early in the pandemic.

CONCLUSIONS

Stressors related to the COVID-19 pandemic are strongly associated with adolescent internalizing problems, as are individual differences in emotional reactivity and regulation and their underlying neural mechanisms. Interventions that reduce pandemic-related stressors and foster adaptive emotion regulation skills may protect against adolescent psychopathology during this period of heightened exposure to stress.

Violence Exposure in South African Adolescents: Differential and Cumulative Effects on Psychological Functioning

This study examined the associations between different types of violence victimization and psychological functioning in South African adolescents. Both differential and cumulative effects of violence were investigated. A multi-ethnic (Black, White, people of mixed heritage, and people of Indian/Asian descent) sample of adolescents in secondary schools in the Western Cape Province (N = 1,574; boys = 46.5%, girls = 53.5%; Mage = 16 years) completed a survey on their experiences of exposure to violence (across different contexts and polyvictimization) and their levels of hopelessness, anxiety, depression, perceived stress, and suicidal ideation. The results showed that indirect and direct victimization in the community, and indirect political victimization were consistent predictors for adverse psychological functioning, whereas victimization in home and school contexts did not emerge to be significant. Polyvictimization had a consistent linear effect on psychological symptoms. Interventions in South Africa should focus on addressing the psychological effects of community and political victimization on adolescents. Adopting a holistic treatment approach would be useful to gain a comprehensive understanding of adolescents' victimization experiences and maximize the impact of support to enhance their psychological functioning.

Emotional Dysregulation in Adolescents: Implications for the Development of Severe Psychiatric Disorders, Substance Abuse, and Suicidal Ideation and Behaviors

Well-tuned emotional regulation is fundamental for human life and psychological well-being. Negative physiological emotions are counterbalanced by positive ones, and this equilibrium is the mainstay of human physiological affective states. However, this mechanism may sometimes become dysfunctional when negative emotions are not correctly counterbalanced, causing maladaptive behaviors, especially during adolescence. A very interesting review by Young et al. was recently published (Brain Sci.2019, 9(4), 76) and stimulated us to reflect on this topic. The screening for emotional disturbances and dysregulation in adolescents must be included in all the preventive and interventional programs aimed to achieve both physical and psychological well-being of the population and early intervention should be provided in order to avoid progression toward clinically relevant psychiatric disorders in late adolescence and adulthood.

Effects of Age and Gender in Emotion Regulation of Children and Adolescents

Emotional regulation, understood as the skills and strategies needed to influence and/or modify the emotional experiences, has a very remarkable implication within numerous emotional and behavioral disorders in childhood and adolescence. In recent years there has been a significant increase in research on emotional regulation, however, the results are still divergent in terms of differences in emotional regulation in relation to age and gender. This study aimed to assess emotional regulation in adolescents in relation to their age and gender. Two hundred and fifty-four adolescents from eight schools in the Valencian Community and aged between 9 and 16 years participated in the study. The adolescents completed the Cognitive Emotion Regulation Questionnaire and the FEEL-KJ questionnaire. We analyzed the differences in emotional regulation strategies and a latent emotional regulation variable in two age groups (9-12 years and 13-16 years) and by gender. The results suggested that children and pre-adolescents in the 9-12 year group obtained lower scores in the emotional regulation strategies than the 13-16 year group. Girls reported higher scores on the use of emotional regulation strategies when experiencing sadness, anxiety and anger than boys, and on the overall average of regulation according to these specific emotions. Age, but not gender, had a major effect on scores for the latent variable of emotion regulation. An interaction effect between age and gender was identified in the latent emotion regulation scores. Girls tended to have higher scores than boys when they were younger and lower scores than boys when they were older. These results could be relevant for designing prevention and intervention programs for adolescents and at different ages.

Negative affective stress reactivity: The dampening effect of snacking

The present study sets out to further elucidate the complex relationship between daily hassles, snacking, and negative affect (NA). The aim of the present study was to examine whether or not moment-to-moment energy intake from snacks moderates the association between momentary stress and NA. And, if so, can this moderating effect be replicated by using the amount of macronutrient intake (i.e., carbohydrates, fat, and protein) as moderator on the association between momentary stress and NA? Adults (N = 269), aged 20-50 years, participated in this study. Stress, NA, and snack intake were assessed 10 times a day for 7 consecutive days in daily life with an experience sampling smartphone application. Multilevel regression analyses were performed to assess the hypothesized associations. Our study revealed a dampening effect of snacking on negative affective stress reactivity. However, this dampening effect could not be replicated by the amount of macronutrient intake from snacks. On the contrary, the amount of carbohydrates has an enhancing effect on negative affective stress reactivity. In the end, our study suggests that the critical question is which mechanisms are decisive in the dampening role of snacking on stress reactivity. A multidisciplinary approach may provide a full perspective.

Work Stress and Depressive Symptoms in Fishermen With a Smoking Habit: A Mediator Role of Nicotine Dependence and Possible Moderator Role of Expressive Suppression and Cognitive Reappraisal

This study examined pathways of influence between work stress, depressive symptoms, nicotine dependence, expressive suppression, and cognitive reappraisal in fishermen with smoking habits in Qionghai, Hainan province, China (N = 1068). These fishermen responded to multiple assessments a week before leaving on a deep-sea fishing trip, including a Mental Stressor Investigation Questionnaire (MSIQ), the Center for Epidemiological Studies Depression Scale (CES-D), the Russell Reason for Smoking Questionnaire (RRSQ), and an Emotion Regulation Questionnaire (ERQ). Structural equation modeling (SEM) analyses of the collected data in Mplus 7 showed that work stress and nicotine dependence were independent predictors of depressive symptoms. The relationship between work stress and depressive symptoms was found to be partially mediated by nicotine dependence and be moderated by cognitive reappraisal. The evidence suggests it advantageous to examine the need of work stress, nicotine dependence, and cognitive reappraisal when attempting to understand depressive symptoms in fishermen with a smoking habit. These findings suggest that improving nicotine dependence through work stress management and training in cognitive reappraisal could be utilized as effective modalities for improving depressive symptoms.

Confirmatory Factor Analytic Structure and Measurement Invariance of the Emotion Regulation Questionnaire for Children and Adolescents in a Longitudinal Sample of Adolescents

While adolescence is a critical stage of development marked by heightened bottom-up emotional reactivity and immature top-down regulatory control, research on emotion regulation has relatively neglected middle childhood to adolescence years. This may be attributed to the limited number and scope of age-appropriate, reliable, and valid measures of emotion regulation. This study examines the confirmatory factor analytic structure and measurement invariance of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), a 10-item self-report measure designed to measure habitual use of cognitive reappraisal and expressive suppression, across a 1-year time interval in school samples of adolescents. Results indicate low test–retest reliability but high to acceptable internal consistency over a 1-year time period. The two-factor model has an approximate but close fit to the data collected, which is consistent with underlying theoretical framework and prior empirical findings. Tests of measurement equivalence support strong invariance, indicating that there were no statistically significant differences in factor means, variances, and correlations over a 1-year interval.

The Relationship Between Perceived Family Support and Depressive Symptoms in Adolescence: What is the Moderating Role of Coping Strategies and Gender?

This study examined the moderating role of gender and coping strategies in the relationship between perceived family support, self-esteem and depressive symptoms. Data were used from the My World Survey Second Level (MWS-SL), a national survey of mental health among 6062 young people aged 12-19 years. Conditional process analyses indicated that planned coping moderated the relationship between perceived family support and depressive symptoms for those engaging in low-moderate levels but not high levels of planned coping, and this moderating role was stronger for females than males. Avoidance coping was a moderator for those engaging in moderate-high but not low levels of avoidance coping, and gender also moderated this relationship. Support-focused coping only moderated the perceived family support/depressive symptoms relationship for females. Findings suggest that the strength of the relationship between perceived family support and depressive symptoms depends on level of engagement with a particular coping strategy, and this engagement is a consistently stronger moderator for females.

Adverse Life Experience and Psychological Distress in Adolescence: Moderating and Mediating Effects of Emotion Regulation and Rumination

The current study tested whether emotion regulation and rumination moderated and/or mediated the relationship between accumulated adverse life experience and psychological distress in adolescence. In class, Australian high school students (n = 2637, 12-18 years, 68% female) from 41 schools completed well-validated measures of adverse life experience, emotion regulation, rumination and psychological distress, and were followed up 1 year later (n = 1973, 75% retention rate). Adjusting for age, gender and baseline psychological distress, adverse life experience predicted psychological distress 1 year later. Expressive suppression and rumination were positively associated with psychological distress. Cognitive reappraisal was negatively associated with psychological distress and moderated the relationship between adverse life experience and psychological distress. This relationship was also partially mediated by cognitive reappraisal, expressive suppression and rumination. Promoting cognitive reappraisal and minimizing expressive suppression and rumination may be useful strategies to improve mental health for adolescents who have experienced adverse life events. Future research should examine whether adolescents who have experienced adverse life events can be trained in effective emotion regulation strategies and whether this training can prevent development of psychological maladjustment. Copyright © 2015 John Wiley & Sons, Ltd.